N.J. Admin. Code § 11:4-28.9

Current through Register Vol. 56, No. 24, December 18, 2024

Section 11:4-28.9 - Excess and other nonconforming provisions

(a) A plan with order of benefit determination rules which comply with this subchapter (complying plan) shall coordinate its benefits with a plan that declares itself "excess" or "always secondary" or which uses order of benefit determination rules which are inconsistent with those contained in this subchapter (noncomplying plan) on the following basis:

1. If the complying plan is the primary plan, it shall pay or provide its benefits on a primary basis;

2. If the complying plan is the secondary plan, it shall:

i. Attempt to secure the necessary information from the noncomplying plan to make the determination of the complying plan's liability as the secondary plan; or

ii. Assume the primary position and pay its benefits as the primary plan, if the noncomplying plan is unwilling to act as the primary plan or does not supply the information necessary for the complying plan to determine its benefits as a secondary plan.

N.J. Admin. Code § 11:4-28.9

Amended by R.2002 d.106, effective 4/1/2002 (operative January 1, 2003).
See: 33 New Jersey Register 2578(a), 34 New Jersey Register 1440(a).
Rewrote the section.